This week, Missouri politicians proposed new language to the federal reimbursement allowance (FRA), a must-pass Medicaid funding bill that lawmakers failed to pass during the regular session because of language blocking patients’ access to contraception. The bill includes medically inaccurate language. As your newsroom considers coverage of Medicaid in Missouri, we want to provide medically accurate facts around birth control and emergency contraception. This document is intended to serve as a resource to Missouri press in the effort to combat misinformation that conflates contraception and abortion.
What is the FRA?
Despite federal law that requires Medicaid to cover contraception, Missouri politicians derailed the Federal Reimbursement Allowance (FRA) at the 11th hour on the last day of session. The FRA is a tax on certain providers, and it draws down federal funds that make up about one-third of the entire budget for Missouri’s Medicaid program. The FRA normally passes without fanfare every year, but it failed this session because a senator hostile to contraception added language to prohibit these funds from covering common forms of birth control. This anti-contraception language risks the state’s entire Medicaid program.
Without a clean FRA bill renewing the provider tax, Gov. Parson may have to divert funds from general revenue to pay for Medicaid, destabilizing the entire budget including potentially K-12 and higher education, infrastructure and other programs that support children, those with disabilities and older Missourians.
Why attack contraception?
Senators opposed to contraception and abortion are purposely and inaccurately conflating the two. They continue to spread misleading information about emergency contraception (a.k.a. Plan B, ella, the morning-after pill) and intrauterine devices (IUDs), calling them “abortion drugs.” Their campaign to conflate contraception with abortion contradicts how these contraceptives work: they prevent pregnancy, they do not end it.
The most recent anti-birth control amendment circulating could impact many types of birth control, because it could ban funding for any contraception with levonorgestrel, an ingredient found in many types of birth control, including pills, patches, and IUDs.
Politicizing public health is a dangerous habit that Missouri politicians need to quit. This is clear political gamesmanship designed to hold hostage funding for Missouri’s Medicaid program and attack patients who rely on contraception just so politicians can restrict Missourians’ health care. As a result, the state’s entire Medicaid program hangs in the balance, including access to services for the hundreds of thousands of Missouri patients — the majority of whom are women — who rely on Medicaid for their health care.
Medicaid only covers abortion in limited circumstances in Missouri.
Current federal law prohibits Medicaid funds from being used for abortion through the Hyde Amendment, a racist and discriminatory law that blocks federal funds from being used to pay for abortion outside of the exceptions for cases of rape, incest, or life endangerment. State Medicaid law also prohibits Medicaid funds from being used for abortion. The most recent anti-birth control amendment circulating only has an exception for life endangerment.
Withholding essential health care harms Missourians.
Birth control is not affordable for everyone, which is part of what makes Medicaid such an important program. In fact, because of racist and discriminatory policies, people of color and women disproportionately rely on publicly funded programs like Medicaid for health care, including affordable birth control and other sexual and reproductive health care.
We know that 99 percent of sexually active women will use at least one form of contraception at some point in their lifetimes, whether for family planning or other medical reasons like treating endometriosis. Birth control should be treated like any other preventive medical care.
Statement from M’Evie Mead, director of Planned Parenthood Advocates in Missouri:
“Let’s be clear: this is an attempt to restrict birth control and confuse Missourians about basic health care. Using medically inaccurate rhetoric to shape health care policy is dangerous. Missourians cannot afford these irresponsible political games.
“These politicians are holding hostage a must-pass bill so they can block patients’ access to common forms of birth control — and they’re willing to risk funding for the entire Medicaid program to do it. Hundreds of thousands of patients rely on Medicaid to access essential health care, including birth control. Decisions about birth control belong to a patient and their provider — not state legislators.”